Q: How have trends in cancer death rates for children and adolescents in the United States changed over time?

SC:This report presents recent trends in cancer death rates for children and adolescents in the United States, at the turn of and during the first part of the 21st century. Cancer deaths to children and adolescents had been declining since the 1970s through the end of the 20th century. This report shows that the decline continued from 1999-2014, by 20%. The declines were for both males and females aged 1-19, for all 5-year age groups within the 1-19 age range, and for white and black children and adolescents.

Q: What type of cancer is taking our young people in the United States now – and which kind of cancer has been the greatest cause of death for youth over the years?

SC:I think when you say “childhood cancer”, most people first think of leukemia, as this type of cancer had been the leading type for decades–both in terms of incidence and deaths. However, what our report shows is that there was a shift during the 1999-2014 period, and the leading type of cancer causing death in children and adolescents aged 1-19 years is now brain cancer. This is a recent development as the number of brain cancer deaths first exceeded that of leukemia in 2011; 2014 was the first year that this difference was statistically significant.

Q: Was the decline experienced for all age groups within the 1-19 years of age range?

SC:Yes, all 5-year age groups experienced declines, with the youngest children, those aged 1-4, having the largest percentage decline of 26%. In 2014, death rates for children ages 1-4, 5-9, and 10-14 years were not significantly different from each other, while rates for older adolescents aged 15-19 were the highest of all groups.

Q: What are the trends among race and ethnicity groups in cancer death rates for young Americans?

SC: This report shows that there is parity in cancer death rates among white and black children and adolescents aged 1-19. The parity was there for all three years–1999, 2006, and 2014–and both groups experienced declines over the period.

Q: What do you think is the most significant finding in your new study?

SC: Probably the recent shift in the leading site, from leukemia to brain cancer. This is a noteworthy development in the history of childhood cancer as it was always leukemia until quite recently. Brain cancer deaths to children and adolescents aged 1-19 did not go up over the time period studied, but rather, fluctuated and remained stable. It was the decline for leukemia deaths that caused the crossover in numbers so that the percentage of all cancer deaths is now highest for brain cancer, accounting for 3-in-10 cancer deaths in 2014 for the pediatric population.